Document Detail

Endovascular management of inadvertent subclavian artery catheterization during subclavian vein cannulation.
MedLine Citation:
PMID:  20171903     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To retrospectively review a 9-year experience with endovascular management of inadvertent subclavian artery catheterization during subclavian vein cannulation.
MATERIALS AND METHODS: From June 2000 through July 2009 (109 months), 13 patients underwent endovascular management of inadvertent subclavian artery catheterization. All catheters were still in situ, including one 7-F catheter, six 8-F catheters, and six large-bore 10-11-F catheters. Treatment was performed with an Angio-Seal device (n = 6) or balloon catheters (n = 7) and by additional stent-graft placement (n = 4).
RESULTS: Mean follow-up was 27.3 months (range, 0.4-78 months). The 30-day mortality rate was 7.7% and the late mortality rate was 46.1%. Primary technical success was achieved in nine patients (69.2%), in four with the use of a compliant balloon catheter and in the other five with an Angio-Seal device. Complications required additional stent-graft placement in four patients (30.8%), one because of stenosis after Angio-Seal device deployment and three as a result of insufficient closure of the puncture site by balloon tamponade. Stent-graft repair was successful in all four patients, for a primary assisted technical success rate of 100%.
CONCLUSIONS: Endovascular techniques offer a less invasive alternative to surgery. The present limited experience shows that the use of the Angio-Seal device is not without risks, whereas balloon tamponade is not always reliable in closing the puncture site. Stent-graft placement may be required in patients in whom balloon tamponade fails or in whom the use of the Angio-Seal device is contraindicated.
Andreas P Chemelli; Franz Wiedermann; Josef Klocker; Juergen Falkensammer; Alexander Strasak; Benedikt V Czermak; Peter Waldenberger; Iris E Chemelli-Steinguber
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-02-20
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-07-16     Revised Date:  2010-12-01    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  470-6     Citation Subset:  IM    
Copyright Information:
Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria.
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MeSH Terms
Aged, 80 and over
Balloon Dilation / methods*
Balloon Occlusion*
Catheterization / adverse effects*
Middle Aged
Subclavian Artery / injuries*
Subclavian Steal Syndrome / therapy*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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